People equate eating meat with eating fat. The lean part of the meat itself is almost 100% protein. It is the fat that attaches to the meat that causes the cholesterol level to rise. I emphasize lean meat and avoiding animal fat. Trimming off the visible fat when you eat will eliminate most of the animal fat. Since you cannot separate the fat in regular ground beef from the meat part, it is not allowed in our diet unless it is extra-lean. Sources of fat should come from fish and olive oil. Do not confuse this diet with the Atkins diet, which allows salt and all kinds of animal fat, e.g. side bacon, whole egg, and cheese. High serum cholesterol is due to eating bad fat and carbohydrates and not from eating cholesterol.

Does your diet allow the use of artificial sweeteners?

There are many kinds of artificial sweeteners on the market that are readily available. The first one is saccharin. The FDA no longer claims that saccharin is a cancer-causing agent if taken in moderate amounts. One bad side effect of using saccharin is that it can stimulate the pancreas to release insulin. It also leaves a bitter after-taste. Cyclamate (Sweet'N Low and Sugar Twin ) is thirty times sweeter than sugar and is sold in Canada and the United Kingdom but is banned in the United States. There is no evidence that it causes cancer. It contains 0.5 g of carbohydrates per package. Aspartame (Equal ) is a sweetener that is two hundred times sweeter than sugar. It has 0.5 g of carbohydrates per teaspoon. Since it does not have a bitter after-taste like saccharin, it is used in diet pop extensively. However, it is not stable in heat and cannot be used in cooking. Sucralose (Splenda ) has been available in Canada for many years. It is six hundred times as sweeter than sugar. It also has no after-taste and it is stable in heat. It is going to replace aspartame in diet pop soon. Splenda is not carbohydrate free. It carries 0.5 g of carbohydrates per teaspoon and only 1/8th the calories of sugar. No ill effect has been reported to date. Acesulfame Potassium (Sunett ) is the newest sweetener and is about 200 times sweeter than sugar. Stevia is a natural sweetener extracted from a plant. It has no calories and has no side effects. Some preparations of Stevia may cause after-taste effects. It has been recently approved by the FDA to use in diet soft drinks.

Your diet does not let me eat cheese; will I develop osteoporosis?

Eating protein and fat has no effect on bone mass. Inadequate protein intake compromises bone health and contributes to osteoporosis in the elderly16. If you are drinking more than 3 cups of caffeinated drinks per day while not taking calcium will lead to bone loss. An increase in dietary sodium will lead to an increase in sodium loss in urine. Urine calcium loss will also go up. Hence a low sodium diet will be more suitable for patients with osteoporosis.

Your diet promotes a lot of weight loss in the short term. Will I regain my weight once I go off the diet?

This is the most common complaint when a patient comes into our office. “I lost 50 pounds on Weight Watchers (or Doctor Bernstein's Diet , or Jenny Craig , etc). However, I gained all my weight back, and more!” When you go into their diet history, you will find that the patient has returned to their old eating habits after stopping the diet program. The patient did not follow the maintenance program. The patient will regain the weight if he or she begins to eat the wrong way. It would be a surprise if the patient did not regain the weight. The diet did not fail the patient, but rather the patient failed the diet. Just like a home gym set up. It helps you to gain some muscle while you are doing the exercises. When you stop using the home gym, you lose the muscle that you gained. You cannot say that the home gym failed to work. You failed because you did not follow through with the plan. Just like using chlorine to control algae in the swimming pool. As long as you are using the chemical, there is no algae growth. When you stop using the chlorine, algae will start to grow. This does not mean that chlorine is ineffective towards algae control. You have to continue to use it to get the desirable effect. Obesity is a chronic disease that has no “cure,” but it can be controlled. You need to be careful in choosing your food for the rest of your life. Lipoprotein lipase is an enzyme found in abundance near the fat cells in obese subjects, which facilitates the conversion of triglycerides in the circulation into fat storage inside the fat cells. The more lipoprotein lipase, the easier is to gain fat weight. It was found that even with major weight reduction, the lipoprotein lipase level did not return to normal. This may help to explain why obese people regain their weight and not because of the type of diet.